Search PubMed⌕ Search

Biomedical subjects

M D Cohen

Publications and source records attributed to M D Cohen.

At least 199 records · Page 11Linked to original sources

Hiatus hernia: a complication of postero-lateral diaphragmatic herniation (Bochdalek hernia) in infants.

During the six years from January 1973 to Februrary 1979, 23 infants with postero-lateral diaphragmatic (Bochdalek) hernias have been treated in the Paediatric Surgical Unit of the General Infirmary at Leeds. Surgical repair was performed in all cases. Ten patients died. Severe vomiting occurred in seven (54%) of the 13 survivors. Barium meal demonstrated large hiatus hernias in four (31%) of the 13 survivors. This previously unreported complication of Bochdalek hernia repair should be consideredin all patients with vomiting following surgical repair of a Bochdalek hernia.

Diaphragm↗

Tubes wires and the neonate.

The structure and function of the various tubes and wires that may be seen on radiography of neonates undergoing intensive care are described. The desired position for these and some examples of the consequences of malposition are considered and illustrated; practical conclusions are made.

Catheterization↗

Intravenous urography in neonates and infants. What dose of contrast should be used?

The dose of contrast to be used for IV urography in neonates and infants is discussed. Toxic levels are only just above the currently accepted doses of 2-4.4 ml contrast medium per kg bodyweight. The dangers of expressing the dose of contrast medium as a volume of contrast related to the patient's age are discussed. A case is presented who had a severe reaction following an acceptable dose expressed as volume for age, but probably excessive when expressed as ml per kg bodyweight. It is concluded that for IV urography in neonates and infants the dose of contrast must be related to weight of patient and not its age; no dehydration should be used; and the injection should be slow, taking about three minutes.

Age Factors↗

Transient small bowel intussusception in adult coeliac disease.

Considerable disagreement exists in the literature concerning the occurrence and incidence of transient non-obstructive intussusception in adult coeliac disease. Only a few case reports have been published and several standard texts do not mention the association at all. We report six adult patients, all with coeliac disease, who demonstrated transient non-obstructive intussusception on small bowel meal examination. The technique of the small bowel meal and the radiological signs of malabsorption are briefly described. The literature is reviewed and reasons for the disagreement herein are discussed. We conclude that the incidence of finding intussusception in adult coeliac disease is related to the intensity of searching and in our series this association was seen in at least 20% of cases. It is considered to be an additional radiological sign of coeliac disease although in no case did it occur in the absence of other prominent radiological evidence of malabsorption.

Adult↗

New approaches in the therapy of the peripheral vascular ulcer.

It can readily be seen that Debrisan represents a more effective mode of therapy for several groups of patients which tend to have chronic disabling ulcers of limbs of various etiologies, including venous stasis ulcers, chronic sickle-cell ulcers, decubiti, etc. The more effective treatment of this patient populations, which is provided by Debrisan, would provide a very significant decrease in the total cost of health care in the United States, approximating half a billion dollars per year.

Adolescent↗

Pharmacology of some oral penicillins in the newborn infant.

Serum and urine concentrations of ampicillin, amoxycillin, and flucloxacillin achieved after oral administration have been measured in 27 newborn infants. Compared with adults and children, newborn infants show a delay in achieving adequate blood concentrations, presumably due to delayed absorption. However most infants achieve therapeutic concentrations in the serum. Infected newborn infants should be given these antibiotics by intramuscular injection for the first dose, but thereafter oral therapy (25 mg/lg every 6 hours begun concomitantly) should be satisfactory. The better absorption of amoxycillin compared with ampicillin reported in adults has not been confirmed in the newborn infant.

Administration, Oral↗

Primary pulmonary hypertension: an unusual case associated with extrahepatic portal hypertension.

A patient with both extrahepatic portal hypertension and primary pulmonary hypertension is reported. The pulmonary hypertension developed without a surgical portal-systemic shunt, and at autopsy there was no evidence of a large spontaneous shunt. This association of pulmonary arterial hypertension and portal venous hypertension without either intrinsic liver disease or a large portal-systemic anastomosis has not been reported previously. Our case supports the concept that portal hypertension with its attendant portal-systemic collateral circulation may be the major predisposing cause of pulmonary hypertension both in intrinsic liver disease and extrahepatic portal vein obstruction.

Adolescent↗

Magnetic resonance imaging of inflammatory lung disorders: preliminary studies in children.

Magnetic resonance(MR) scans were performed on 14 children with a variety of inflammatory disorders of the lungs. MR successfully identified disease in all of the children and accurately localized the disease within the lung fields. In patients with pneumonia and lung abscesses the acute inflammation was associated with a marked increase in signal intensity on T2 when compared with T1 weighted images. One patient with an inflammatory pseudotumor demonstrated a smaller increase in signal intensity on T2 weighted images than was seen in acute pneumonia. Abscess cavities were well identified along with the wall thickness. In patients with diffuse lung disease (diffuse histoplasmosis, miliary tuberculosis, Letterer-Siwe disease, and allergic alveolitis), each disease appeared different on the MR images. These preliminary studies indicate that magnetic resonance imaging is effective for identifying pulmonary disease in children and may improve the radiologist's ability to differentiate pulmonary disorders.

Adolescent↗

Total parenteral nutrition in mice bearing a metastatic carcinoma: tumor growth, metastasis and immunologic parameters.

The role of dietary manipulation of tumor growth, metastasis and immunologic parameters was studied in mice bearing Lewis lung carcinoma. Fourteen days following subcutaneous tumor implant, groups with tumor and their non-tumor bearing counterparts were assigned to one of the following feeding protocols: total parenteral nutrition (TPN), per oral (PO) intake of the parenteral diet, an oral casein diet (CAS), or electrolyte infusion plus the casein diet (ELECT). Intakes of energy and nitrogen were similar among all groups. Mice were killed 12 days later and peritoneal macrophages were tested for phagocytic activity. Tumor growth and metastasis were decreased from both infusion regimens with minimal loss of body weight as compared with casein fed mice. PO mice also showed lower tumor weight but metastasis was as great as in the casein group. Non-tumor-bearing infused mice showed depressed thymic weight, but thymic weight was not further reduced in tumor-bearing infused mice. PO feeding afforded no such protection in the presence of the carcinoma. Splenomegaly was observed in tumor-bearing mice on all regimens, but mice maintained on the parenteral diet demonstrated the largest proportion of macrophages containing nuclear debris. Analysis of free macrophages indicated no effect of diet regimen on non-immune phagocytic activity in both tumor-free and tumor-bearing mice. Possible alteration of splenic macrophage intracellular digestive capacity or phagocytic activity was suggested as a result of TPN.

Animals↗

Right-to-left shunt from systemic venous to pulmonary venous system developing after SVC obstruction.

This report and review of the literature describe a rare form of right-to-left shunt found in patients with superior vena cava (SVC) obstruction. Following SVC obstruction, collateral vessels may develop between the systemic venous system and the pulmonary venous system causing the alveolar space and right heart to be bypassed. Perception of this unusual shunting of blood on enhanced chest CT may help explain clinical symptoms of hypoxia.

Child↗

The detection of pulmonary metastases by helical CT: a clinicopathologic study in dogs.

PURPOSE: We sought to determine the accuracy of helical CT in the detection of pulmonary metastases. METHOD: Four anesthetized dogs with metastatic osteosarcoma underwent helical CT with a collimation of 5 mm, a pitch of 2, and a reconstruction interval of 5 mm. All macroscopically evident metastases were recorded at autopsy. CT images were independently reviewed by 10 radiologists and compared with pathologic results. Alternate slices in the dog with the most metastases were microscopically examined in their entirety. RESULTS: Pathologic examination of the lungs revealed 132 macroscopically evident pulmonary metastases, of which 74 (56%) were detected by at least one reader. Forty-four of the 99 (44%) metastases of < or = 5 mm in diameter were detected by at least one reader compared with 30 of 33 (91%) metastases of > 5 mm in diameter (p < 0.0001). The 10 readers reported a total of 107 false positives. Complete microscopy of alternate slices in the dog with the most metastases (n = 68) revealed an additional 38 micrometastases of < or = 3 mm in diameter. None of the 32 micrometastases of < or = 1 mm were detected by CT. CONCLUSION: Helical CT has some limitations in the detection of pulmonary metastases.

Animals↗